FAQs: Our Contract with Humana

Humana Medicare’s agreement with SLV Health will be ending at the end of this year, 2025. Beginning on January 1, 2026, SLV Health’s hospitals, clinics, providers and services will be offered to those on Humana Medicare Advantage plans on an Out of Network basis.

Why is the agreement ending between Humana and SLV Health?

Multiple reasons contributed to this decision, chief among them the experience that many SLV Health patients have had with the insurer. Patients have reported difficulties with receiving the benefits they were promised when signing up for the insurance. SLV Health staff has repeatedly witnessed denials and barriers that have negatively impacted patients and resulted in delays in services, prompting the decision to end the contract with the insurer. It is important that we maintain fair and responsible agreements with insurance companies. As a non-profit organization, these agreements allow us to keep up with the rising cost of care, treat underserved patients, and continue to invest in our communities each year.

When does this change take effect?

The contract between San Luis Valley Health and Humana Insurance will expire
at midnight on December 31, 2025. SLV Health will continue to accept Humana as in-network through December 31, 2025.

What if I have a Humana Supplement plan?

Humana's Medicare Supplement insurance plans are not Medicare Advantage plans and not impacted by the agreement ending on December 31, 2025.

For facts about Medicare Advantage, click here to access an info sheet put together by the Colorado Hospital Association.

Which SLV Health locations will be affected by the expiration of the agreement with Humana?

All of SLV Health's hospitals, clinics, providers and services as of January 1, 2026.

What options do I have to change my Medicare Advantage Plan?

You can take action to explore a different Medicare plan during the Medicare Annual Enrollment period. The Medicare Annual Enrollment Period begins October 15, 2025 and is active through December 17, 2025. Patients may also shift to a different Medicare Advantage plan one time during the Medicare Advantage open enrollment period between January 1 and March 31, 2026.

Who can I contact with further questions?

We deeply value you as our patient and want to do all we can to ensure you can maintain full access to providers and nurses you trust. To learn more about the Medicare Enrollment periods and when you're eligible to make changes to your plan, visit Medicare's website at Medicare.gov or, visit CMS.gov for more information. You can also contact the SLV Area Agency on Aging and speak with the certified State Health Insurance Assistance Program (SHIP) Coordinator for assistance with navigating plan options by calling (719)589-4511.

Now that San Luis Valley Health is out-of-network with Humana, what does that mean for me as a patient?

Being out-of-network with Humana simply means we no longer have a contract with that health plan. Our commitment to you has not changed. You will continue to receive the same high-quality care, attention, and dedication from our team as always. While this may affect certain aspects of the billing process depending on the type of visit, your care and experience with us will remain the same.

Am I still able to go to the ER at SLV Health?

Of course! All patients can utilize both the ER at the Regional Medical Center in Alamosa and the Conejos County Hospital in La Jara, regardless of payer status. Additionally, all services provided during your ER visit, including imaging, emergency surgery, inpatient admissions and transfers or direct admits, are billed as in-network. This is true for all out-of-network insurances. You may still have to pay your standard Humana Medicare copay, please refer to your specific plan for details.

Can I still receive other services at SLV Health?

Absolutely! You can still utilize ALL of San Luis Valley Health’s services at ALL of our locations, regardless of your payer status. The only difference is that for all ambulatory and outpatient services, which include things like clinic visits, imaging or labs, you will just be considered out-of-network.

How does the billing work if I get seen at SLV Health now that I’m out-of-network?

The first thing to know is that we work with patients that are out-of-network all the time. Many tourists, ASU students and others traveling in the San Luis Valley are out-of-network and utilize our services. How it works is that you will receive a Good Faith Estimate for your visit and you will have to pay a portion of that amount at the time of your visit. For Humana, insurance authorization is still sent in and you may receive a bill for any remaining balances. Please refer to your specific plan for details.

Do I have to submit my own claim after my visit?

You don’t have to file claims on your own, we’re here to help. If you have Humana, SLV Health will submit a claim on your behalf.

If you have questions regarding this change, please call our Business Office at (719)587-5711. Please note that SLV Health cannot recommend any health plan or help with enrollment.